Surgical stitching apparatus



M' tflth L4, 1944. v 3; wlLSON ETAL 2,344,071

SURGICAL STITGHING APPARATUS Filed Oct.-5, 1942 2 Sheets-Sheet 1INVENTORS. v GERALD A. W/LsoN L YMAN E. SPENCEP THE IR Arron/var March14, 1944. a. A. WlLSON ETAL SURGICAL STITCHING APPARATUS Fil ed Oct. 5,1942 2 Sheets-Sheet 2 uvmvroxs.

Patented Mar. 14, 1944 SURGICAL STITCHING APPARATUS Gerald A. Wilson andLyman E. Spencer,

Detroit, Mich.

Application October 5, 1942, Serial No. 460,740

4 Claims. (Cl. 1-491) th combination of a clamp for clamping togethertissue to be dissected and a stitching head movably associated with oneof the clamp members providing reliableand positive operation, andimproved visibility and the parts of which are of a simplified, ruggedconstruction convenient to i,

assemble or separate.

It is a further object of our invention to provide an improved stitchinghead or carriage for such apparatus.

Further objects and advantages are within the scope of my invention suchas relate to the arrangement, operation and function of the relatedelements, to various details of construction and to combinations ofparts, elements per se, and to economies of manufacture and to numerousother features as will be apparent from a consideration of thespecification in conjunction with the drawings disclosing a form of myinvention, in which:

Fig. 1 is a side elevationa1 view of the clamp in opened position, thestitching head being removed;

Fig. 2 is a side elevational view showing the clamp closed with thestitching head in operative position on the upper clamp member;

Fig. 3 is a cross-sectional view taken on line 33 of Fig. 2;

Fig. 4 is a cross-sectional view taken along line 4-4 in Fig. 3;

Fig. 5 is a greatly enlarged fragmentary view of short portions of thetwo clamping members in clamped relation, showing the space providedtherebetween, staples, a stapling plunger, and the staple guiding slotsand clinching surfaces being represented by dotted lines; and

Fig. 6 is an enlarged fragmentary detail view, partially broken away andsectioned, to show the quick detachable clamp joint.

Referring more particularly to Fig. 1 of the drawings, our surgicalstitching apparatus comprises a clamp for holding together the dissectedtissues which are to be stitched together. The clamp, which is shownopen in Fig. 1 consists of a, pair of clamp members II and I 3 hingedtogether at one end on a pivot pin I5 for relative pivotal movement. Theopposite ends of the clamp members are suitably shaped to provideconvenient handles I! to be gripped for swinging the members togetherand closing the clamp to secure the edges of tissues therebetween.

A latch I9 is provided in a slot 2| centrally disposed in the handle endof the upper clamp member II where it is pivotally journalled upon apivot pin 23. The latch I9 extends toward the lower clamp member l3 and,when the clamp is closed, it projects into a slot 25 centrally disposedin the handle end of the lower clamp member where it engages around orunder a latch pin 21. A lever 29 extends from the latch I9 and projectsfrom the upper clamp member in a convenient position for manipulation.

After the clamp members have been manually gripped together lever 29 andthe latch I9, which are initially in the dotted line position as shownin Fig. 2, are rotated counter-clockwise to the full line position sothat the latch passing under the pin 21 secures the clamp together.

An abutment 3i rises from the end of the lower clamp member I3 adjacentthe handle and engages the adjacent side of the other clamp member IIproviding a predetermined space 33 between the two pivoted clampmembers, when these are latched together as shown in Fig. 2, so thatclamped tissues are firmly secured without injurious crushing. The pivotI5 at the other or hinged end of the clamp is so made that the space 33is uniform throughout the length of the clamp.

Secured along the upper portion of one side of the upper clamp member Il is a rack tooth strip 35 which is secured snugly by rivets 31 in arecess in the upper left-hand corner of the cross section, as shown inFig. 3. The rack teeth 39 project from the strip 35 above the upper sideof the upper clamp member I I. Guide grooves 4| are cut in both oppositesides of the upper clamp member II extending therealong from the pivotend and opening at the end adjacent the handle. Secured on and extendingalong opposite sides of the lower portion of the upper clamp member I Iare a pair of staple retaining strips 43 secured as by welding, and eachhaving staple receiving slots 41 in the side adjacent the clamp. Theslots 41 are of a cross-section elongated lengthwise of the clamp andare uniformly spaced and arranged in pairs on opposite sides of theclamp member, as shown in Figs. 3, 4 and 5.

A stitching head 59 is slidably mounted upon the upper clamping memberH. This head 50 comprises a body 5| having side plates 53 secured to theopposite sides of the body by conveniently removable knurled nuts 54 onthe opposite ends of screws 55 extending therethrough. The upper edgesof the side plates 53 are preferably arranged to be even with the upperside of the body 5|, and the lower edges of the side plates projectsubstantially below the body for extending in guiding relation along theopposite sides of the upper clamp member Ii whereon the stitching headis movably disposed in operation. Guide pin screws 55 are passedthreadably through the lower extending portions of the side plates 53into the guide grooves M in the opposite sides of the clamp member I l.The stitching head is conveniently installed upon the handle end of theupper clamp member I i with the guide pins 55 in the guide grooves 5!,which grooves are cut open toward the handle end for this purpose.

A pair of plungers 51 are slidably disposed on opposite sides of thehead in grooves 59 cut in the inside surfaces of the side plates. Toprovide for reliable operation with a minimum number of parts, theplungers 5? are preferably th legs of an integral U-shaped member whichis inverted in the head. The lip-turned yoke 6!} thereof is engaged by asuitable cam 61 which is secured, as by a screw 63, on a shaft 65extending rotatively through a shaft bracket 61 up rising from the uppersid of the body. The shaft bracket 63 has a pedestal flange 69 securedon the body by screws 'H. The shaft 65 is rotated manually by means of acrank 13 attached on the upper end of the shaft by a screw 15. As shown,the cam BI is preferably cut axially on a cylindrical shell and the camsurface engages a roller H which is disposed in a slot 19 and journalledon a pin 8! in the yoke 60 of the plungers to provide for lightoperation with a minimum of friction. A compression spring 83 reactingbetwen the bottom of the yoke 60 and the upper portion of the body 5ielevates the plungers 51.

As the crank 13 is turned manually, the cam (ll is rotated and depressesthe plungers 51 once in each revolution. The lower ends of the plungerspass down into the respective pairs of staple retaining slots 41 insuccession.

In order to advance the head along the clamp and to accurately positionit to insert the plungers 5'l into each pair of staple slots 4?, therotatable shaft 65 passes down through an aperture in the body 5| of thehead, as shown in dotted lines in Fig. 3. The lower end of the shaft 55carries a kicker 85 secured or integral thereon and rotating in a recess81 in the head and just above the upper side of the clamp member I l, asshown in Fig. 4. The kicker 85 is of a suitable shape and length forengaging the spaced rack teeth 39 one-bY-one to advance the head onetooth for each revolution of the shaft.

To hold the head firmly in each advanced position while the plungers arebeing depressed, a detent disc 89 is pressed through an aperture 9| sopositioned in one of the side plates that the detent rides over the rackteeth 39 and lodges in the space between two teeth just as the plungersare in alignment with a pair of slots.

The detent disc 89 is continuously pressed toward the rack teeth 39 by acompression spring 83 engaging the outer edge of the disc which isprovided with a tubular member 95 for receiving the end of the spring.The outer end of the spring 93 reacts against an adjusting cap '91 whichadjustably screws on a tubular detent socket 59 having a flange lillsecured to the side plate. The detent socket 99 is provided with a pairof slots I03 in diametrically opposite positions for receiving andslidably guiding the edges of the detent disk 89.

'Fig. 6 shows the quick detachable pivot joint which provides for quickand convenient assembly or separation of the two clamp members. Thepivoted end of the upper clamp member H is provided with a hinge ringI05 of a suitable thickness to be inserted between a pair of membersIll? extending in spaced relation from the end of the lower clamp memberl3, and one of which is shown broken away in Fig. 6. The pivot pin E5passes through the spaced members I01 and has on the intermediateportion two flattened areas its on opposite sides having the effect ofproviding a reduced diameter. The hinge ring I05 is provided with abearing aperture III of suitable size to rotatively journal the fulldiameter of the journal pin IS. A pivot pin receiving slot 8 l3, havinga width equal to the reduced diameter or thickness of the pivot pin, iscut through one side of the hinge ring H into the bearing aperture. Theslot H3 and the flattened pivot pin l5 are so positioned as to be out ofaligned relation when the clamp members I l and I3 are in clampingposition. The two clamp members may be quickly hinged together, orseparated, by turning the two parts to the position wherein theflattened or reduced diameter of the pivot pin [5 is aligned with theslot H3 in the 80 hinge ring H35.

35 alloy, plastics, or the like.

0 one end and handles and latch at the other end,

and also because of the uniform space 33 provided between the clampmembers, the tissues are clamped with a uniform pressure and the clampmembers are not bowed out of shape.

The stitching head 59, is slidably applied upon the upper clamp member il with the guide screw pins 55 entering the guide grooves ii in oppositesides with the crank l3 turned to a suitable position to elevate theplungers 57 and to turn the kicker to a disengaging position. Thestitching head is pushed along the clamp to the pivot end. Thearrangement of the two rows of staple slots is such as to be clearlyvisible and it can be conveniently ascertained if the slots have allbeen correctly loaded with staples. Also the operation of the apparatuscan be clearly observed.

The crank 13 is manually turned rotating the shaft 65, the plungeractuating cam Si, and the kicker 85. While the spring pressed detentdisk 89 is lodged between two rack teeth and holds the head, the camdepresses the two plungers 51 which simultaneously enter staple slots 47on opposite sidesof the clamp. As a plunger 5'! enters a staple slot 47,the staple H5, which was previously loaded therein, is pushed toward thelower clamp member 13, piercing the clamped tissues and entering theclinching depressions H1 in the lower member, as represented by dottedlines in Fig. 5. This causes the staple ends to be turned under, and iscontinued clinching the staples and securing the tissues H9 together. Asthe plungers 5-! are elevated, the kicker 85 ad vances the stitchinghead 53 one space, where the head is again held by the spring presseddetent disc 89 between the next pair of rack teeth 39. The cam 61 againdepresses the pair of plungers 51 into the next pair of staple slots 41,and this operation is successively repeated until the stitching head hasadvanced to the handle end. By releasing the latch lever 29, the clampis conveniently removed.

The stitching head is conveniently removed from the clamp and the clampmembers are easily separated. Also it will be apparent that the parts ofthe head are conveniently separable so that the instrument may becleansed and sterilized.

Although we have shown and described a certain specific embodiment ofour invention, we are fully aware that many modifications thereof arepossible. Our invention, therefore, is not to be restricted exceptinsofar as necessitated by the prior art.

We claim:

1. Surgical stitching apparatus comprising, two elongated clamp memberspivotally joined at one end for clamping together dissected tissuesalong the edges of an incision to be stitched, a row of staple slotsaligned along each side of one of the clamp members, each of the stapleslots being elongated parallel to the elongated dimension of the clampmember and of a size suitable for receiving a clinch staple, a stitchinghead for stitching tissues, cooperatively engaging means on said headand on one of the pivoted clamp members for holding the head slidablythereon, a

pair of plungers movably disposed in the head,

said plungers being shaped and positioned in each side of the head fordriving staples through adjacent slots, position determining surfaces onthe clamping member carrying the head for positioning the head andplungers in alignment with the staple slots, and manually operativemeans on said head for actuating the plungers and for controlling themovements of the head along said clamping means.

2. Surgical stitching apparatus in accordance with claim 1, and furthercharacterized by the staple slots being arranged in evenly spaced pairson opposite sides of the clamp member, the pair of plungers being thelegs of a U-shaped member, and the manually operative means including acam engaging the yoke of the U for simultaneously reciprocating the pairof plungers.

3. In a stitching head for use on a surgical clamp for stitching tissuesheld in the clamp, a body member, two side plates secured one on eachside of the body, a pair of plungers, a guide recess slidably mountingone of the plungers in each side of the head, a manually rotative shaft,means journalling the shaft on the head, and cam means actuated by theshaft for depressing the plungers.

4. In a stitching head for use on a surgical clamp for stitching tissuesheld in the clamp, a body member, two side plates secured one on eachside of the body, an inverted U-shaped element comprising, a pair ofextended plungers and an interconnecting yoke, a guide recess slid ablyreceiving one of the plungers in each side of the head, a manuallyrotative shaft rising vertically above the body, means journalling theshaft on the head, and cam means actuated by the shaft for engaging theyoke and depressing the plungers.

GERALD A. WILSON. LYMAN E. SPENCER.

